Physician Compare National (NPI:1457475881)

HEALTHCARE PROVIDER: ADALBERTO MENDOZA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1457475881
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860620317
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140108001823
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MENDOZA
	Individual professional last name
Provider First Name	ADALBERTO
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1974
	Individual professional's medical school graduation year
Primary Specialty	PATHOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SOUTHERN PATHOLOGY SERVICES INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7214259506
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	PARQUE INDUSTRIAL SABANETA
	Group Practice or individual's line 1 address
City	PONCE
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	00716
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7878418645
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	400044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAN LUKE'S MEMORIAL HOSPITAL INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	400103
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MAYAGUEZ MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	400123
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HOSPITAL PEREA
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	400113
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	HOSPITAL SAN CRISTOBAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	400003
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	HOSPITAL METROPOLITANO DR PILA
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1457475881)

HEALTHCARE PROVIDER: ADALBERTO MENDOZA MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information